Differential therapy of radial head fracture: a critical analysis based on outcome of 53 patients

Abstract

We investigated 53 patients with 57 radial head fractures (4 patients with bilateral fractures) treated between 1993 and 1998. We focused on patients with radial head fractures asking about (1) the relation between fracture type and therapy and (2) the correlation between chosen treatment and result. We saw the following fractures: Mason I: 3 cases, Mason II: 26 cases, Mason III: 11 cases, and Mason IV: 15 cases. Good results were achieved by 30 patients with 31 fractures, fair results by 8 patients with 9 fractures, and poor results by 13 patients with 14 fractures. Patients with a Mason I fracture achieved good results with functional therapy. Of the 26 Mason II fractures, 14 were treated with screws, 14% of whom had poor results subjectively. Six patients were treated with a K wire, titanium nail, or prevot nail, none of whom had poor results. Of 11 patients with a Mason III fracture, 10 were treated by resection of the radial head, and in 1 patient we implanted a prosthesis due to an intraoperatively detected elbow instability after resection and achieved good postoperative results. Only one patient (9%) had poor long-term results subjectively. Of 15 patients with a Mason IV fracture, 11 were treated by resection of the radial head: 5 patients (33%) had poor long-term results, only 3 of whom (20%) subjectively considered the results poor.